Rapid-deployment or transcatheter aortic valves in intermediate-risk patients?

Piergiorgio Bruno, Francesco Burzotta, Filippo Crea, Carlo Trani, Massimo Massetti, Alessandro Di Cesare, Marialisa Nesta, Federico Cammertoni, Andrea Mazza, Lazzaro Paraggio, Raphael Rosenhek

Risultato della ricerca: Contributo in rivistaArticolo in rivista

2 Citazioni (Scopus)

Abstract

Background Transcatheter aortic valve implantation and rapid-deployment aortic valve replacement represent two emerging therapies for patients with intermediate surgical risk and severe aortic stenosis. However, head-to-head comparisons between such novel therapies are lacking. Methods Severe aortic stenosis patients with intermediate surgical risk treated with rapid-deployment valve replacement at our institution were identified and compared with a propensity-matched population of patients who underwent transcatheter aortic valve replacement. Postoperative echocardiographic findings, in-hospital and midterm clinical outcomes were compared. Results We identified 60 patients who received transcatheter (n = 30) or rapid-deployment (n = 30) valve replacement. On postoperative echocardiography, freedom from paravalvular regurgitation was higher in the rapid-deployment valve group (p < 0.001), while postoperative mean transprosthetic gradient was lower in the transcatheter valve group (p = 0.03). Permanent pacemaker implantation was required more frequently in transcatheter valve patients (p = 0.01). Postoperative atrial fibrillation was more common in the rapid-deployment valve group (p = 0.03). Hospital mortality was similarly low in both groups (p = 0.33). At midterm follow-up, mortality was comparable (p = 0.42) but the rapid-deployment valve group still had a lower degree of paravalvular regurgitation. Conclusions Transcatheter and rapid-deployment valve replacement are promising treatment options for patients with intermediate surgical risk. These two techniques are associated with specific patterns of prosthesis function and postoperative complications. Further evaluation of the clinical impact of these therapies in this patient population is needed.
Lingua originaleEnglish
pagine (da-a)264-270
Numero di pagine7
RivistaAsian Cardiovascular and Thoracic Annals
Volume25
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Aortic stenosis
  • Aortic valve
  • Cardiology and Cardiovascular Medicine
  • Heart valve prosthesis implantation
  • Minimally invasive surgical procedures
  • Pulmonary and Respiratory Medicine
  • Surgery
  • Sutureless surgical procedures
  • Transcatheter aortic valve replacement

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